Does experience play a role in the ability to perform liver stiffness measurements by means of supersonic shear imaging (SSI)?

Oana Gradinaru-Tascau, Ioan Sporea, Simona Bota, Ana Jurchis, Alina Popescu, Madalina Popescu, Roxana Sirli, Milana Szilaski

Abstract


The aim of this study was to identify if the experience of the examiner does plays a role in the ability to perform liver stiffness (LS) measurements by means of supersonic shear imaging (SSI) due to the lack of recommendation regarding this issue. Material and methods: The study included 371 consecutive subjects (42% men and 58% women, with a median age of 48 years, ranging between 17-85 years) with or without hepatopathies, in which LS was evaluated with an AixplorerTM ultrasound system (SuperSonic Imagine S.A., Aix-en-Provence, France). Reliable LS measurements by means of SSI were defined as the median value of 5 LS measurements expressed in kilopascals (kPa). The SSI measurements were performed by a novice (with less than 300 abdominal ultrasound examinations performed) or by a more experienced operator (with approximately 500 ultrasound examinations performed). The results of both operators were compared. Results: The novice performed 57.4% and the more experienced operator 42.6% of the SSI measurements. The more experienced operator had a higher rate of reliable examinations as compared with the novice: 87.4% vs. 72.8% (p =0.001). The rate of reliable measurements was similar for novice and experienced operator in patients with a normal weight (BMI < 25 kg/m2) and in overweight patients (BMI between 25.1 – 29.9 kg/m2), 92.3% vs. 97.5%, p=0.24, respectively 71.1% vs 80.4%, p=0.39. For obese patients (BMI ≥ 30 kg/m2) the rate of reliable LS measurements was significantly higher for the more experienced operator as compared with the novice: 73.4% vs 45.9%, p=0.03. Conclusions: It seems that experience in liver ultrasonography plays a role in the ability to perform LS measurements by means of SSI and leads to achieving more reliable LS measurements especially in obese subjects.

Keywords


Supersonic Shear Imaging; transient elastography; Acoustic Radiation Force Impulse elastography; liver stiffness

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DOI: http://dx.doi.org/10.11152/mu.2013.2066.153.ogt1is2

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